The Relationship Between Agency Characteristics and Quality of Home Care

ABSTRACT. Background. This project assessed the relationship between home care quality indicators HCQIs) and agency characteristics. Methods. Twelve agencies completed a mailed survey on a variety of characteristics, including size of their caseload and for-profit (FP) status of contracted service providers. The HCQIs were derived from standardized assessments completed voluntarily for home care clients in Ontario and in Manitoba, Canada. Results. The average caseload was 121.3 clients per case manager, and over 40% of nursing, personal support and therapy providers were considered FP. For individual HCQIs, few correlations were statistically significant. An overall summary measure of quality was correlated with the size of the population served (r = _0.80; p \u3c 0.05) and the number of clients per case manager (r = _0.56; p \u3c 0.1). Conclusion. These data represent unique information on home care quality and organizational characteristics in Canada. The question remains as to how best to use HCQI data to inform practice in an era of limited resources and increasing caseloads

The Role of Medications in Predicting Activity Restriction Due to a Fear of Falling

Objectives: To examine the role of medication use and other factors in predicting activity restriction due to a fear of falling (AR/FF). Methods: Older adults were assessed twice with the interRAI Community Health Assessment and the Berg Balance Scale (BBS). The main outcome was limiting going outdoors due to an AR/FF. Medications were recorded by trained assessors. Results: Participants (n=441) had a mean age of 80.3 (sd=7.1) years, most were aged 65+ (96.8%) and 29.3% reported activity restriction. Taking nervous system active or cardiovascular medications was associated with AR/FF. In a multivariate model, the main predictors were having 3+ comorbid health conditions, lower (i.e., worse) scores on the BBS, having difficulty with climbing stairs, and having a visual impairment. Discussion: Modifiable risk factors, related to functional impairments, such as difficulties with balance and vision, appear to be more important predictors than medications

The health and well-being of older adults with dual sensory impairment (DSI) in four countries

Objectives Dual sensory impairment (DSI) is a combination of vision and hearing impairments that represents a unique disability affecting all aspects of a person’s life. The rates of DSI are expected to increase due to population aging, yet little is known about DSI among older adults (65+). The prevalence of DSI and client characteristics were examined among two groups, namely, older adults receiving home care services or those residing in a long-term care (LTC) facility in four countries (Canada, US, Finland, Belgium). Methods Existing data, using an interRAI assessment, were analyzed to compare older adults with DSI to all others across demographic characteristics, functional and psychosocial outcomes. Results In home care, the prevalence of DSI across the four countries ranged from 13.4% to 24.6%; in LTC facilities, it ranged from 9.7% to 33.9%. Clients with DSI were more likely to be 85+, have moderate/severe cognitive impairment, impairments in activities of daily living, and have communication difficulties. Among residents of LTC facilities, individuals with DSI were more likely to be 85+ and more likely have a diagnosis of Alzheimer’s disease. Having DSI increased the likelihood of depression in both care settings, but after adjusting for other factors, it remained significant only in the home care sample. Conclusions While the prevalence of DSI cross nationally is similar to that of other illnesses such as diabetes, depression, and Alzheimer’s disease, we have a limited understanding of its affects among older adults. Raising awareness of this unique disability is imperative to insure that individuals receive the necessary rehabilitation and supportive services to improve their level of independence and quality of life

Sharing clinical information across care settings: the birth of an integrated assessment system

Background: Population ageing, the emergence of chronic illness, and the shift away from institutional care challenge conventional approaches to assessment systems which traditionally are problem and setting specific

Identifying mental health symptoms in children and youth in residential and in-patient care settings

This study demonstrates the use of the interRAI assessment instruments to examine mental health symptoms in children and adults within residential and in-patient care settings. Regardless of service setting, children exhibited more harm to self and others than adults. Children in adult in-patient beds were more likely to exhibit suicide and self-harm and less likely to exhibit harm to others compared to children in child-specific service settings. Implications related to service system improvements are discussed

Pengaruh Kombinasi Senam Kaki Dan Aromaterapi Terhadap Abi Dan Tingkat Stres Pada Penderita DM Di Puskesmas Jajag

Ankle Brachial Index (ABI) merupakan salah satu pemeriksaan dini pada untuk mengetahui insufisiensi arteri sebagai salah satu komplikasi dari diabetes mellitus. Dimana insufisiensi arteri merupakan keadaan pembuluh darah yang berkurang aliran darah yang berakibat iskemia jaringan. Selain itu pada pasien dengan diabetes mellitus juga dapat timbul permasalahan stress sebagai dampak dari penyakit menahun yang dialami. Salah satu metode penatalaksanaan kedua kondisi diatas adalah kombinasi senam kaki diabetic dengan aroma terapi. Penelitian ini bertujuan menganalis pengaruh kombinasi senam kaki dan aromaterapi terhadap ankle brachial index dan tingkat stres pada penderita diabetes mellitus. Penelitian ini menggunakan desain pre and post test group design with control group. Populasi penelitian ini pasien di wilayah kerja Puskesmas Jajag . Tehnik sampling purposive sampling dengan besar sampel 32 orang. Alat pengumpulan data kuesioner dan observasi, dianalisa dengan uji wilcoxon. Keputusan diambil dengan membandingkan nilai probabilitas p value < 0.05. Hasil penelitian menunjukkan uji Wilcoxon ada pengaruh senam kaki dan aromaterapi terhadap nilai ABI dengan p value 0.004 dan ada pengaruh senam kaki dan aromaterapi terhadap tingkat stress dengan p value 0.001. Senam kaki adalah kegiatan atau latihan yang dilakukan oleh pasien DM untuk mencegah terjadinya luka dan membantu melancarkan peredaran darah bagian kaki. Senam kaki dapat memperbaiki sirkulasi darah dan mencegah terjadinya kelainan bentuk kaki. Sementara itu Aroma terapi dengan menggunakan minyak essensial yang dinilai dapat membantu mengurangi bahkan mengatasi gangguan psikologis dan gangguan rasa nyaman seperti cemas, stress, depresi, dan sebagainya Untuk meningkatkan nilai abi maka diharapkan pasien untuk rutin melakukan senam kaki diabetic. Sementara itu untuk meningkatkan relaksasi dan menurunkan tingkat stress, pasien diabetes mellitus dapat melakukan aktifitas aroma terapi

MANAGING THE MASSES - DEVELOPING AN EDUCATIONAL DASHBOARD FOR LECTURERS IN LARGE-SCALE LECTURES

The article presents a method to the development of a dashboard for large-scale lectures (more than 100 students) based on information derived from educational IT-applications, which play an increasingly important role in the field of university education. Via mobile devices, IT-applications enable students to interact with lecturers as well as their fellow students in large-scale settings, e.g. forum or chat. From a service perspective, lectures can be enhanced by the real-time provision of relevant and useful data. However, data created by the use of IT applications is not yet systematically used to support lecturers\u27 tasks, i.e,. by providing contents in a well-defined course setting. Feedback comes in the guise of information gathered through the adoption of said devices, e.g,. on what students have understood and which students are intellectually engaged. We are thus in the process of developing a dashboard, which collects information during the lectures to support lecturers\u27 increasing interaction. We are collecting design requirements based on experts and the literature. These have led to a mock-up which we designed according to literature and expert requirements. We introduce our planned steps to validate the proposed design guidelines through the implementation and evaluation of a proof-of-concept prototype dashboard

VALIDITY OF THE INSTRUMENT interRAI EMERGENCY SCREENER FOR PSYCHIATRY FOR THE BRAZILIAN CONTEXT

Objective: The aim of this study was to carry out the translation and present the evidence of validity of the Brazilian version of the interRAI Emergency Screener for Psychiatry (ESP). Method: this is a cross-sectional study conducted in a municipal hospital in the metropolitan region of Porto Alegre, Rio Grande do Sul. A total of 161 patients were evaluated in the first 24 hours of emergency arrival using ESP. Exploratory factor analyses of the sections of the instrument and reliability analyses were conducted using Cronbach's alpha and McDonald's Omega. Results: the analyses suggested an appropriate structure to the purpose of the instrument, two sections containing two factors instead of the expected one-dimensional structure. However, sections with two factors have interpretability and theoretical consistency. The factors presented internal consistency. Conclusion: the Brazilian version of the interRAI Emergency Screener for Psychiatry (ESP) demonstrates adequate psychometric properties through the internal structure of the instrument. Future studies should investigate the relationship of the scores produced by the instrument with clinical diagnosis and with covariates relevant to mental health outcomes.Objetivo: El objetivo de este estudio era realizar la traducción y presentar la evidencia de validez del examinador de emergencia interRAI para psiquiatría (ESP). Método: se trata de una encuesta transversal realizada en un hospital municipal de la región metropolitana de Porto Alegre, Rio Grande do Sul. Un total de 161 pacientes fueron evaluados en las primeras 24 horas de llegada de emergencia utilizando ESP. Los análisis exploratorios de factores de las secciones del instrumento y los análisis de fiabilidad se llevaron a cabo utilizando Cronbach's alpha y McDonald's Omega. Resultados: los análisis sugirieron una estructura adecuada a los propósitos del instrumento, dos secciones que contienen dos factores en lugar de la estructura unidimensional esperada. Sin embargo, las secciones con dos factores tienen interpretabilidad y consistencia teórica. Los factores presentaron consistencia interna. Conclusión: la versión brasileña del Examinador de Emergencia InterRAI para Psiquiatría (ESP) demuestra propiedades psicométricas adecuadas a través de la estructura interna del instrumento. Los estudios futuros deben investigar la relación de las puntuaciones producidas por el instrumento con el diagnóstico clínico y con covariables relevantes para los resultados de salud mental.Objetivo: O objetivo do estudo foi realizar a tradução e apresentar as evidências de validade do interRAI Emergency Screener for Psychiatry (ESP). Método: trata-se de uma pesquisa transversal realizada em um hospital municipal da região metropolitana de Porto Alegre, Rio Grande do Sul. Foram avaliados 161 pacientes nas primeiras 24 hs da chegada a emergência utilizando o ESP. Foram conduzidas análises fatoriais exploratórias das seções do instrumento e análises de fidedignidade por meio do alfa de Cronbach e Ômega de McDonald. Resultados: as análises sugeriram uma estrutura adequada ao propósito do instrumento, sendo duas seções contendo dois fatores ao invés da estrutura unidimensional esperada. Contudo, as seções com dois fatores possuem interpretabilidade e consistência teórica. Os fatores apresentaram consistência interna. Conclusão: a versão brasileira do interRAI Emergency Screener for Psychiatry (ESP) demonstra adequadas propriedades psicométricas por meio da estrutura interna do instrumento. Estudos futuros deverão investigar a relação dos escores produzidos pelo instrumento com diagnóstico clínico e com covariáveis relevantes para os desfechos de saúde mental

PRINCÍPIOS E VALORES DOS ESPECIALISTAS QUE DÃO SUSTENTAÇÃO ÀS PRÁTICAS DE APOIO MATRICIAL EM SAÚDE MENTAL

The research aimed to identify the principles and values that support matrix support in mental health in Primary Health Care. It reports a qualitative study, done with matrix supporters in mental health, from metropolitan region in Porto Alegre, Brazil. The instruments used were semi-structured interviews and a focus group. For data treatment, content analysis was used in the thematic modality. Results show that the principles which justify the practices are guided by the wish to work in a community, shared responsibility, communication skills, care for people’s lives and the development of a symbolic network mediated by bonds. Values that support the work process are based on care, on availability to interact and on dialogic communication. It may be concluded that personal and professional principles and values constitute the core that supports everyday practices.La investigación tuvo como objetivo identificar los principios y valores que sustentan el apoyo matricial en salud mental en la Atención Primaria de Salud.  El estudio és cualitativo, realizado con apoyadores matriciales en una localidad de la región metropolitana de Porto Alegre, RS, Brasil.  Los instrumentos utilizados fueron entrevistas semiestructuradas y un grupo focal. Para el tratamiento de los datos se utilizó el análisis de contenido en la modalidad temática. Los resultados muestran que los principios que justifican las prácticas son guiados por el deseo de trabajar en la comunidad, la responsabilidad compartida, por las habilidades de comunicación, la atención ao curso de vida de las personas y el apoyo de una red simbólica mediada por los vínculos. Los valores que sustentan el proceso de trabajo se basan en la atención, la disponibilidad de la interacción y la comunicación dialógica. Se puede inferir que los principios y valores personales y profesionales son una amalgama que impregna y sustenta las prácticas en el cotidiano.A pesquisa teve por objetivo identificar os princípios e valores que subsidiam o apoio matricial em saúde mental na Atenção Primária à Saúde. Estudo com abordagem qualitativa, realizado com apoiadores matriciais de um município da região metropolitana de Porto Alegre, Brasil. Os instrumentos utilizados foram entrevistas semiestruturadas e grupo focal.  Para o tratamento dos dados utilizou-se a análise de conteúdo na modalidade temática. Os resultados evidenciam que os princípios que justificam as práticas são norteados pelo desejo de trabalhar na comunidade, a reponsabilidade compartilhada, as habilidades de comunicação, a atenção ao curso de vida das pessoas e a sustentação de uma rede simbólica mediada pelos vínculos. Os valores que sustentam o processo de trabalho estão alicerçados no cuidado, na disponibilidade de interagir e na comunicação dialógica. Pode-se depreender que os princípios e valores pessoais e profissionais constituem um amálgama que perpassa e sustenta as práticas no cotidiano